Sign-up surge marks final weeks of Md. health exchange enrollment

State surpasses revised goal but misses original benchmarks

A surge of nearly 50,000 Marylanders obtained health coverage through the state's insurance exchange during the final two weeks of enrollment despite continued technical difficulties.

The website, which allowed users to sign up for private plans and Medicaid under the Affordable Care Act, had seen hundreds or a few thousand sign up each week before the final surge. More than 18,000 enrolled in private plans in the second half of March, officials announced Friday.

"I would say we finished very strong," state Health Secretary Dr. Joshua M. Sharfstein said, crediting volunteers and community health organizations for a final push. "At certain points along the way, we didn't think we'd get anywhere near this kind of enrollment."

The website crashed on the first day of enrollment, and after months of technical problems, contractor disputes and leadership turnover, state officials dumped the site Tuesday in favor of using software developed for the more successful health exchange used in Connecticut.

Americans who did not sign up for health insurance by the end of March face a penalty, and a last-minute surge in enrollments was seen nationally. Many had delayed decisions on providers or were held up by technical problems. On the last day of enrollment, Maryland's website slowed to a crawl and all circuits were busy at the call center.

State officials will continue sign-ups for those who were unable to navigate the marketplace's troubled website, and those whose applications were stuck in the system or who attest that they couldn't even log on will not be penalized.

But already, officials are saying that they exceeded their goal for overall enrollment, both in private plans and Medicaid, of 260,000. More than 295,000 residents obtained health coverage during the enrollment period from Oct. 1 to March 31, mostly through Medicaid.

President Barack Obama said this week that 7.1 million people nationwide signed up for private health plans through online insurance marketplaces, exceeding most expectations.

But in Maryland, the goal had been revised down from the state's initial projections. In the months leading up to exchange enrollment, state officials expected to reach a goal of enrolling close to 150,000 Marylanders in private insurance plans but changed that to 70,000 in February. Sharfstein has said researchers made a mistake in making the original projection.

The state said Friday that 63,002 Marylanders have enrolled in private health plans through the exchange. An unknown number of people have also gotten coverage directly through four private insurers.

Nonetheless, critics said state officials shouldn't claim victory.

"While I'm extremely happy for every Marylander that received coverage during the enrollment period, I'm disappointed that the state continues to misrepresent the performance of the state exchange by claiming they exceeded their goal when in fact they came up far short," Rep. John Delaney, a Democrat representing Western Maryland and parts of Montgomery County, said in a statement.

Sharfstein credited community health workers known as navigators for working around technical problems in the system to start or complete enrollments. The applications of about 10 percent of those enrolled in a health plan were completed manually, at least in part bypassing the website.

Increased staffing in the exchange's call centers also helped improve enrollment during the final push, as compared with a scramble at the end of last year to enroll people in time for plans that became effective Jan. 1, Sharfstein said. A surge in sign-ups was also noticed at that time.

Those who continue to enroll through April 18 are signing up for coverage that begins May 1. The next enrollment period begins in November.

Exchange officials kept a list of residents who started the process but were stymied by glitches, and officials said those who registered with the exchange's hotline by March 31 will receive a call back from a consumer assistance representative to complete enrollment. And those who experienced technical issues on the website and were unable to enroll will be able to do so online in the coming weeks, officials said.

By next fall, officials expect to have a new website in place. The board that oversees the exchange voted unanimously Tuesday to adopt software developed by Deloitte Consulting and used in Connecticut.

Sharfstein said that the state will negotiate an emergency $40 million to $50 million contract with Deloitte to develop the site and that Isabel FitzGerald, secretary of the state's Department of Information Technology, will oversee the project.

Sharfstein told a congressional panel in Washington on Thursday that the state may pay back some of the federal funds it spent on the faulty site, and blamed IT contractors for the rollout problems.